A fellow physician was having problems with a persnickety patient, so Mayo Clinic cardiologist Steve Ommen, M.D., agreed to have a look at the man. But entering the visit with incomplete information, the doctor ended up spending some three hours answering questions in the middle of a heavily scheduled workday.
If Ommen had known more about his patient's state of mind beforehand, beyond the medical condition, he might have canceled some appointments to better calibrate his day. With cases like that in mind, the Rochester, Minn.-based health system is championing the use of smart Web forms that ask open-ended questions, along with specific clinical ones, to paint a clearer picture of each patient's goals and expectations heading into the appointment. Some visitors might just need a go-ahead for surgery or the next step in their care, while others know little about their disease and desire extra attention.
"Trying to sort that out ahead of time just helps us to understand how we are going to attack today knowing about these patients. Should we be moving some appointment slots around? Should I send a nurse in while I spend more time with another? It just helps us triage and get a battle plan for the day, essentially," Ommen says.
Mayo has started to explore ways to gather more details from patients who schedule appointments or request information about the clinic, which is all part of a larger effort to reduce costs and improve the patient experience. Researchers there have performed dozens of ethnographic interviews, peeling back the "patient onion" and determining what "health" means to each individual, says Meredith DeZutter, a designer at Mayo's Center for Innovation.
They found that patient encounters can veer in various directions based on medical condition, along with their attitudes and beliefs about health care, social support networks or communication preferences. Receptionists who handle calls for Mayo have limited time and loads of work volume, and further questioning over the Web could get each visitor to the right person and place. Sample queries include: What are your goals and expectations for your visit? Do you have any questions or concerns that we can address while you're here? Sometimes, the fashion in which each question is answered, whether long-winded or left blank, can tell a doctor just as much as the answer itself, DeZutter says.
"It's a complex system, and our goal is to learn as much as possible before the patient comes here," she says. "Because when we learn something brand new while they're sitting in front of a doctor, that's probably the worst time to then try to make adjustments."
It's too early to determine how much of an impact the smart Web forms have had on cutting costs, but Mayo is considering rolling out the forms in all departments in 2014.
"Ultimately, this just helps me understand my patients better, particularly their perceived needs around their visit with me," Ommen says.